Can ckd cause these problems?

[doubleaaaron]

Recently I Have had chest pain, palpitations, and shortness of breath. There have been times recently that I have nearly passed out and doing any activities pretty much whipes me out for energy. Also as of late I have had quite a bit of itching all over my body, but mostly my legs. I have had swelling in my legs for a while now and sometimes in the rest of my body. I know fluid retention can cause shortness of breath, but I was wondering if any of the other problems I have could come from my kidney? My kidney function a couple of months ago was 51. I am not sure what it is now. I figure since I have felt worse that maybe it has dropped a little. Could things like this happen this early? Thanks, aaron.

[DoriSchatell]

Anemia (a shortage of red blood cells) can cause shortness of breath, fatigue, and feeling wiped out--but I've never heard that it causes chest pain or palpitations. Many of the conditions that cause kidney disease can ALSO cause heart problems. I urge you to contact your doctor--you may even want to go to the ER and get an EKG done to be sure that your heart is okay. When you see your doctor (or the ER), you might also ask for a serum creatinine level so they can check your kidney function again--it may well have dropped. Often, this happens slowly, but it can be fast.

Anemia, if you have it, can also cause heart damage. Anemia can and should be treated with Aranesp or Procrit. Ask your doctor about this, too.

[doubleaaaron]

I never thought about anemia causing it, but it makes sense. I Have had problems for a while now with my kidney, but as of late (last 2 months or less) I have had chest pains as I described. I was starting to get used to being tired and having back and side pains, but now that my chest won't stop bothering me I will go and get checked. Hopefully I can get some answers. Plus my back is getting worse and I have had foamy urine for a while now. I have been going to the bathroom less lately and mostly at night. So I will ask about those things as well. I have not seen a doctor since I have had chest problems because I was afraid of them telling me that I have anxiety or something and I know that isn't what's wrong with me. Is it possible that since I have been to the doctor that these things could have got worse or happened all together? The last few times that I went to the transplant clinic my gfr was lower than it was the last time I was there. Which was only months or less apart. Thanks for the help, Aaron.

[DoriSchatell]

There's no doubt that going to the doctor and being told that what you feel is "all in your head" is a horribly frustrating experience. But sometimes we just have to bite the bullet and go anyway--and then go again if we KNOW something is wrong and the doctor doesn't believe it. Trust yourself and your body.

Things are different for you than they were. Foamy urine, urinating at night, shortness of breath...all of these things suggest that--for whatever reason--your kidney function has slipped further than it was. You seem to be keeping track of your symptoms, which is a good thing--your doctor may be an expert in treating disease, but you are the only expert in how it affects YOU, and you can work more effectively with your doctor if you track and report how you feel--and how it's different.

Do you have a nephrologist (kidney specialist)? If not, it may be time to ask for a referral to one. If you do, go see him again. And definitely do get your heart checked out. Feel free to post here, we're happy to help you figure out what questions to ask, even if we can't answer them ourselves.

[doubleaaaron]

I went to the ER saturday. The nurse told me that my white blood cells were abnormal, my BUN was elevated and my liver enzymes were elevated as well. They want me to see a cardiologist as soon as possible so they can figure out what is going on with my heart. The ekg I had said it was abnormal, but the doctor said that at the moment anyway that I was ok. Or at lest while I was there at the hospital. I will have to see the cariologist to see if I have angina. So I guess they will make me take a stress test. If they don't should I request one? My chest bothers me on and off while resting, but when I exercise it gets worse. My chest pounds horribly and I feel like passing out. I also bothers me after eating. I have been exercising for years and I have also been doing kung fu for many years as well and I have never had this problem until my chest started bothering me a couple of months ago. I was on a monitor and my bp was 150/95. I asked the nurse if it was too high and she said no, which I thought was strange. Especially being that I have one kidney. My TC told me they wanted less than 130/80. Could it be possible that I have an immune system disease Because of white cells, liver, and bun being abnormal? With so many problems I can't figure what is going on anymore. I pretty much just wait and see what the next day brings me hoping I feel better than the day before. Thank you for all your help, Aaron.

[DoriSchatell]

Hi Aaron,

The nurse was wrong and you were right--your BP was high. Sometimes it can be higher in an MD's office than it is at home (they call this "White Coat Hypertension"). If you can afford it, a home BP monitor can tell you more about what it's really like in your day-to-day life.

Since you've been so active, especially, I would definitely ask for a stress test if your doctor doesn't suggest one. It does sound like you know your body well, and you should share that knowledge with your doctor. I'm glad that they're doing some tests and taking this all seriously.

Since I'm not a doctor, I can't comment on whether your problem might be immune related. The number 1 cause of kidney failure is type 2 diabetes, and the number 2 cause is high blood pressure. Beyond that, there are cystic diseases, diseases of the kidney filters (glomerulopathies), immune diseases, birth defects, poisons, etc. that can cause kidney damage. Taking too many NSAIDs (non-steroidal antiinflammatory drugs--like Aleve, Advil, etc.) can harm the kidneys, too.

It sounds like right now, your best bet is to wait for the tests to come back, question your doctor, and keep a log of your various symptoms--when do they happen? Does anything make them better/worse? Are they worse at certain times of day? Have you started any new medications that might have made them worse? Describe them in as much detail as you can and keep the desription in a notebook that you bring with you to your doctor visits. You may want to have a loved one come along, too, so you can both listen.

[doubleaaaron]

I have a bp monitor at home and it is consistant with the numbers at the hospital. I talked to my TC today and she said it was too high and I needed medicine for it so it doesn't damage my kidney. She said it could be an immune disease, but doubts that's what is wrong. The stress test was recomended by my TC as well. I figure since I get chest pain worse when I exercise or anything close to that, they will want to do one. I went to my kung fu class tonight and I had to stop during most of it because I was feeling bad. My instructor even noticed that I was ill. I don't think I will go to anymore classes until I go to the cardiologist. Tommorow I have to call and make an appointment. Hopefully I will see what is going on. Is there anyway that all of the tests being abnormal (white blood cells, bun, liver enzymes) could be wrong or can something cause all of them to be elevated or low? Thank you for helping me and answering my questions, Aaron.

[DoriSchatell]

Hi Aaron,

I wish I could tell you what might cause so many of your blood tests to be "off", but that would take a doctor's knowledge. It's an excellent question, though, so do keep it in mind to ask. It may be that one thing going wrong is causing a "domino effect" by putting more stress on other body systems, so if that one thing is dealt with, everything else will come back into alignment. But I don't know.

I'm glad that you'll be getting blood pressure meds to protect your kidney--it sounds like a good idea. It also sounds as if taking a short break from the kung fu class until you know a bit more about what's going on with your heart would be wise, although in general it's a great idea to stay active and fit.

[doubleaaaron]

As far as the bp meds I have not got them yet my tc just said I needed them and told me to ask the cardioloigist about it. I did have one more question I forgot to ask. If my BUN is elevated could it cause me to itch? Lately I have been scratching, especially my legs. Thanks again, Aaron.

[DoriSchatell]

Itching can be a symptom related to having less kidney function. It may mean that the levels of phosphorus in your blood are also higher than the normal levels. You might ask your doctor about this, too.

[doubleaaaron]

I don't get an appointment with the cardiologist until jan 24. I think that is too long to wait, but I don't know what else to do. I have been getting worse as of last few days, so I hope I can make it till then. I went to walmart today and was walking around for less than a half hour and I felt like falling over. I can't believe it is this hard to get good medical help. Just like my neice with kidney diasease, she went to the hospital several times before they found out what it was and by then she was a lot worse. Do you think I should try something else before my appointment? Or I guess if I get sick I could go to the er again. Deja-vu all over again.

[Beth Witten MSW ACSW]

I've been following the exchange between you and Dori. I don't remember you saying what your blood test showed so far as anemia (hemoglobin/hematocrit). Do you have those results? My brother had heart problems and angina for years. He had a GI bleed that came and went and when he was bleeding and his hemoglobin level dropped, he had angina, dizziness, and shortness of breath. He had had angina for years off and on, but the low hemoglobin made it come on quicker when he did any kind of exertion...even walking short distances. His symptoms usually started when his hemoglobin was 10-11. He even had a couple of mild heart attacks when his hemoglobin was around 7-8. He had to have several transfusions.

So far as your cardiologist appointment January 24, if I were you, I wouldn't want to wait that long not if I was having the symptoms that you're having. Are there other cardiologists in your town? Can you get a faster appointment with someone else? Does the cardiologist know the symptoms that you've been having?

If you live near a city with a medical school, you might want to try to get an appointment there. Although some people don't like being seen by med students, residents and staff doctors, when that many people put their heads together, they usually come up with the most up-to-date recommendations.

I assume when you say TC, this is your transplant clinic. Do you see the nurse and the doctor when you go for your check-ups there? How often do you go to TC appointments? At your last visit, did that doctor see that your BP was high and know that you were having heart palpitations and chest pain? Could that doctor help you get an appointment with the cardiologist sooner?

BTW, the kidney-protecting blood pressure medicines that are commonly given to people with diabetes and kidney disease are in one of two classes of drugs called ACE inhibitors or ARBs. To help reduce your blood pressure without medication, if you smoke, cut back or stop. Limit your intake of salt (look on labels for sodium and in meat look for "enhanced" meat). Limit the amount of caffeine that you drink (coffee, tea, hot chocolate, and soft drinks). I'm sure you're stressed with the health problems you've been having, but try to do things that have helped relieve stress in the past (quiet music, aromatherapy, massage, reading, etc.). If you reduce your stress, it may reduce the palpitations and the high blood pressure some. Although exercise is good for most people, if you have chest pain when you exert yourself, like Dori said, I'd limit the exercise for now.

[doubleaaaron]

I don't know the results of the hemolobin or hematocrit. And they didn't say anything about anemia. The nurse told me that all my tests were fine. I asked about my gfr and she said it was ok. A minute or so later while she was still in the room she began to tell me that my white blood cells were low and my bun and liver enzymes were elevated. I don't know how that makes the test all fine. I hate the hospitals around here. Sometimes I think they have the janitors working as doctors and nurses. The bp monitor showed at or around 149/95 many times. I asked (even though I knew it was high) if it was too high and the nurse said it was perfectly fine. I told her that was great and I guess I can go home now, like nothings wrong. I told my transplant coordinator and she said she would never get medical attention where I live. I live in WV But I donated at Ohio State. TC is transplant coordinator by the way. I don't go to the clinic anymore, but I do talk to the coordinator as through out the process we became friends. I went there for a while afterwards then I was done and told to go to a doctor where I live. I tell her about my problems and she knows about my high bp and can't beleive that noone has done anything about it yet. If I lived there I could have her help me more, but sadly I don't.

As far as the limiting my exercise I deffinatly have started to hold back so nothing further happens. I don't drink coffee or use salt on food so I should be good on that stuff. I have noticed that cold and high temperatures makes me feel worse and my chest acts up more. When its even a little bit warm I feel like passing out and I get rushed with heat and I get really tired. After I eat I feel worse as well. Did anything like this happen to your brother? Could a gi bleed be possible with me as well and does it make vital signs change when it happens? It seems that everytime I go to the hospital I feel better than when I wanted to go. Maybe things don't happen while I am there. I don't know anymore. I do appreciate you and dori's help. Thanks, Aaron.

[Beth Witten MSW ACSW]

If I were you, I'd ask the doctor or nurse every time you have labs if they could make a copy for you to keep. My doctor has no problem giving these to me and I save them in a folder in my drawer. Lab reports always come with a way to flag lab results that are out of the normal range. There are websites online that you can visit to learn more about what the lab test results mean:
-- http://www.kidneyschool.org - kidney-related labs
-- http://www.labtestsonline.org - all kinds of tests

Once you have a copy of your lab tests and you know what the results should be, you may have other questions to ask the doctor or nurse.

So far as whether you have a GI bleed, you could have dark, tarry stools or visible blood. Sometimes it's hard to tell and that's why doctors have people do a fecal occult blood test periodically. If there's blood in your stool, it would show up on that test. You can read about it here:
http://labtestsonline.org/understanding/analytes/fecal_occult_blood/sample.html

From your last post, it sounds like you not a kidney recipient but a kidney donor. Is this true? How far are you from Wheeling? The former chair of our advisory council, Derrick Latos, is a nephrologist in Wheeling and a former president of the Renal Physicians Association.

[doubleaaaron]

Wheeling is farther than OSU is from me. Next time I go to the docotr I will ask for a copy of everything, it is a good ideah. And yes I was a donor to my neice. I have had problems ever since. Only a few days after I donated I had to go back to the hostpital and stay again. I have had to be readmitted several times. I also got sepsis and had to stay in the icu. I have had rough times But not until recently did I have chest problems. last 2 months or less and for the last 3 weeks it has been much worse. Maybe sepsis could have causes damage to my organs. My liver was not working at the time I had it. Also After I had sepsis I noticed that it was harder for the nurse to get iv's started and to keep them working. Thank you for the help, Aaron.

[Beth Witten MSW ACSW]

I am really sorry that you have had so many problems related to donating your kidney. I know that problems donors have are not discussed very often and many people don't realize that they could have problems after donating a kidney. It sounds like you've been through the wringer. I hope that your health problems will be resolved soon.

[doubleaaaron]

I haven't been doing much for exertion for the last few days and I can notice a difference in how I feel. I feel better but also I feel worse at the same time. It's wierd. I can feel good, well ok for half the day then for the rest I feel worse. One hour I feel sick and hot then an hour later give or take, I feel like I am not sick. I only feel ok for short period of time. I pretty much never feel good just ok. And when I do feel better I realize how sick I am because I feel so much better, but I am still sick. Could I have an auto immune diasease or something? I have heard lupus is mostly had by women but men do get it and I have also heard it is hard to detect and symptoms vary daily. I still have the jan 24 appointment so I am just trying to figure out anything I can till then. Can angina or kidney problems cause these type of symptoms to go back and forth? Thanks, Aaron.

[Beth Witten MSW ACSW]

If what you have is angina, the pain can come and go. Usually the pain is worse when you exert yourself and is less when you don't. Angina occurs when the heart muscle doesn't get the oxygen it needs and is caused by a narrowing one or more arteries around the heart. Here's information on angina, including treatment for it. If you have chest pain, I'd suggest that you go to the emergency room as you could have angina or you could be having a heart attack. Chest pain is something to take seriously.
http://www.americanheart.org/presenter.jhtml?identifier=4472

If your liver enzymes are elevated, you might want to read this information from Mayo Clinic about what can cause this problem:
http://www.mayoclinic.com/health/elevated-liver-enzymes/HQ01011

You might want to ask questions about your symptoms on this GI and liver forum:
http://www.medhelp.org/perl6/gastro/